OB/GYN Journals

1.
I’m only a little over a week into this OB/GYN rotation, currently working in labor and delivery. I thought it was amazing to deliver a baby+ placenta on my first shift, today topped it all.  It was both a victorious & humbling night for me. It began with the high… 4 deliveries. I delivered four babies +4 placentas on my own…. And I was on cloud FI-TEEN! YES “fifteen” without the second “f” so you know it’s real. I was so happy to be active, working, participating in the experience of each of these patients, cheering them on. It just felt good, like all the parts of me/my spirit were being utilized at once. That same night I assisted on my first c-section as well. I was excited to see some surgery, excited to lay eyes and hands on some real anatomy again. The uterus is something else y’all. It’s incredible, and the ovaries and fallopian tubes look like you think but they also don’t. There was something abut seeing and feeling them that may me feel closer to myself and more aware of my body I guess? It’s difficult to really nail down the feeling/realization that occurred but it was… good. As I said only a few days into the rotation/night float and I was soaring. Wide awake and happy to be a part of the team. This next part is hard, but it was also I think the most significant part of this night. After witnessing and participating in the what seemed like a constant loop of joy and life, I was reminded of the reality of misfortune regarding pregnancy. We had a case of what’s called “previable premature rupture of membranes”. This means, the patient was going into a very early labor, so early the fetus was far from being developed enough to sustain life. I read up on the diagnosis, the treatment plan, but I still wasn’t sure of how this story would end exactly. This patient, a very kind young woman, labored and delivered a very small, friable (easily torn/bleed), body. It was one of the most difficult things to be a part of. It’s so intimate, ad so painful for the patient. It’s a situation so delicate that you can’t afford any lapses in awareness, sensitivity, service, compassion. She had so much support present for her and her husband that night, which made me feel better for her but it also made me realize that won’t always be the case. You may be the only present source of support in that experience, an unpredictable experience that any mother to be could have, and many do.


 
2.
9/22
It’s almost 0900. I’m just getting home from my 24 hr shift on labor & delivery… and a very unexpected & unpredictable series of events at the grocery store. The last week or so has been hectic, so I knew my best chance of restocking my pantry and replacing “must haves” would be right after this shift. I left checkout around 8 and headed straight to the Wal-Mart nearest my apartment. I made my rounds, picking up necessities as quickly as possible and made my way to the checkout line.
As I enter the area, I notice a frantic woman, crying, face red, hyperventilating, struggling to produce pertinent information to those near her. I’m scanning for the source of her distress, and soon find a man collapsed, pale, and receiving a round of CPR. There’s a couple people around, loved ones of unknown relation,  a Wal-Mart manager, and someone on the phone with EMS. I left my basket and offered to tag in for CPR as needed. I stayed nearby ready to switch out.
Within seconds, the police department was on the scene. An officer came in and forcibly took over CPR. EMS has still not arrived. Another officer approaches a loved one of the man being cared for and tries to get some history on what happened and health information. At this point, the officer doing CPR has been working for a minute, though it felt like ten. There’s a gentleman from ORMC who was also related somehow to the patient who had been around since I got there. He was offering assistance and trying to calmly inform the police officer that his CPR was losing effectivity and the patient needed to be getting mouth to mouth resuscitation in conjunction with the compressions. We’re still waiting on EMS. There are no masks or defibrillators in the store. All we have are the people willing to step in and intervene on behalf of this man who was out getting groceries with his family. Everything was moving so fast & so slow all at once. I’m watching this man go from being pale to completely purple in the face as he only receives compressions. The gentleman from ORMC was insistent on correcting the current technique of CPR and what happened next sent a shockwave through my system. The officer performing CPR starts yelling at the man [ORMC], a loved one and the rest of us offering to assist (a couple nurses, myself, and other certified individuals) to “back the fuck up” and “get the fuck away”. He even has the man from ORMC escorted away by another officer. He continued doing his CPR and never switched out once, until EMS arrived several minutes later. Meanwhile, the woman I mentioned… who was frantic from the beginning is so far from peace now I struggled to understand how she was still standing on her feet. The defibrillator was set up and EMS took over…
I couldn’t even feel completely relieved when EMS arrived because of how long this man had been down, how long he had been receiving poor CPR, how inconsiderate and prideful that officer was. My heart was simultaneously breaking for this man’s family as I watched that young woman fall apart & boiling as I tried to make sense of the officer’s blatant disrespect and disregard for the situation. At this point, I was equidistant between this scene and my grocery cart. I struggled to go back to it, to reassume my position as shopper/exhausted student. I was wide awake and could feel something rising in my chest that I didn’t want to deal with inside this Wal-Mart. I scanned my things quickly and rushed out to my car. I sat there for twenty minutes, letting the frustration and confusion precipitate at the edge of my eyes. My last shift on L&D was full of important lessons, but this experience scorched into my brain what we all claim to already know and we do know…in life but specifically in healthcare, compassion, competency, and awareness are crucial. They are some of the strongest threads interwoven into our humanity. And our humanity cannot be sacrificed. Quality care cannot be sacrificed.
 
*This was the first time (in being certified for 6 or so years) that I have been in an emergent situation requiring CPR. I always thought I would be nervous or scared to offer or approach the scene, that there would be time to feel that way & contemplate if I should, if I really know what to do since I’ve never had to. But there isn’t. There’s no time in the progression of the situation & there’s no time in between the progression of your assessment, processing, and decision making. It’s in you to serve, to help, to care and the words will leave your mouth before you’ve had a chance to feel scared for yourself